《金匮要略》瓜蒌薤白三方治胸痹原意探析

发布时间：2018-03-15 18:09

本文选题：瓜蒌薤白白酒汤　切入点：瓜蒌薤白半夏汤　出处：《中华中医药杂志》2017年05期 　论文类型：期刊论文

【摘要】：《金匮要略》瓜蒌薤白三方一直被学界认为是治疗胸痹痰证的重要经方。但张仲景制瓜蒌薤白三方的原意可能不在于此:首先,从痰的历史发展源流来看,秦汉至晋并无后世独立意义的病理概念之"痰"。《金匮要略》成书年代,多以"淡"代"痰","痰饮"当作"淡饮","淡"主要形容水流动状貌,更遑论明确提出"痰"这一概念;其次,瓜蒌薤白三方的主药瓜蒌、薤白并不符合张仲景"病痰饮者,当以温药和之"的治疗原则;最后,从章节顺序看,瓜蒌薤白三方只出现在《金匮要略·胸痹心痛短气病脉证治第九》中,与痰饮水密切相关的《金匮要略·痰饮咳嗽病脉证并治第十二》和《金匮要略·水气病脉证并治第十四》并未见到应用瓜蒌、薤白治疗痰饮。通过分析《金匮要略》胸痹的病因病机,张仲景应用瓜蒌薤白三方原意,并非专为胸痹之痰治而设,而重在通阳宣痹。后代把瓜蒌薤白三方作为治疗胸痹痰证的重要方剂,可理解为是对"痰"及其相关概念,以及对瓜蒌等药物药味药性的认识不断深化细化的结果。
[Abstract]:Guilou Xiebai Triple has always been regarded by scholars as an important Meridian prescription for treating phlegm syndrome of chest obstruction. But Zhang Zhongjing's original intention of making Guilou Xiebai Xiebai Triple may not be in this way: first of all, from the perspective of the history of phlegm development, Phlegm "phlegm" in Qin and Han dynasties and Jin Dynasty, which has no independent meaning in later generations. In the period of Golden Chamber, phlegm was mostly replaced by phlegm, phlegm was regarded as "light drink", and "light" mainly described the appearance of water flowing, let alone clearly put forward the concept of "phlegm"; Secondly, Guilou Xiebai's main medicine, Trichosanthes trichosanthis and Allium macrostemon, do not conform to the treatment principle of Zhang Zhongjing's "sick phlegm and drink, should be treated with warm medicine and medicine"; finally, from the perspective of chapter order, Guilou Xiebai only appeared in "synopsis of Golden Chamber, chest pain, short Qi Disease Syndrome 9th", The synopsis of Golden Chamber, phlegm and cough syndrome combined treatment 12th > and Golden Chamber synopsis 路water qi disease pulse syndrome 14th > which were closely related to phlegm and drinking water, had not been applied to Trichosanthes. Xiebai Xiebai treats phlegm and drink. By analyzing the etiology and pathogenesis of chest obstruction in synopsis of the Golden Chamber, Zhang Zhongjing's original intention of applying Guilou Xiebai Xiebai was not specially designed for phlegm treatment of chest obstruction. As an important prescription for treating phlegm syndrome of chest arthralgia, it can be understood as the result of deepening the understanding of phlegm and its related concepts, as well as the deepening understanding of the medicinal flavor of Trichosanthes and other drugs.
【作者单位】：中国中医科学院中医基础理论研究所;
【基金】：国家重点基础研究发展计划(973计划)项目(No.2014CB542903) 中国中医科学院基本科研业务费自主选题研究项目(No.YZ-1668)~~
【分类号】：R222.3

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